TABLE 2.

Summary of Themes, Subthemes, and Emergent Codes for Meta-Synthesis of Qualitative Data on Private Sector Engagement in TB Care in India

Overarching ThemesSubthemesEmergent Codes
Context in which the engagement occursPolitical and economic factorsStakeholder interests, reasons for poor interest, social responsibility, market forces
Internal environment of the organizationsNTEP and private sector: value system, vision and goals, organizational structure, culture of organization, stewardship, motivation
Sociocultural factorsStigma, confidentiality, patient preferences
Factors that define the architecture of the engagement and its implementationStrategies for engagement
  • Policy and dialogue: acceptance

  • Regulatory approach: mandatory TB notification, schedule H1 regulation, social regulations–enablers and concerns

  • Incentives: financial and nonfinancial, enablers and concerns

  • Information exchange: enablers and concerns

  • Public provision of services (drugs, diagnostics, training, public health actions): acceptance, concerns

  • Financing: partnership schemes, strategic purchase, insurance, subsidy

Mode of engagementIntermediary agencies, private sector led initiatives, memorandum of understanding, contracts
Resources for engagement

Human resources: adequacy, workload

Other resources: finance, drugs, diagnostics, technological resource, informational resource

Translation of policies to practiceKnowledge gaps, policy translation to practice, implementation of strategies, procedural hurdles and delays, enablers and barriers
Factors related to the actors implicated in the engagementRelationship dynamicsTrust, mutual understanding, prior experiences, accountability, positionality
Capacities to engageManagerial and technical capacities to engage
Interaction of actorsCommunication, interaction, flexibility, coordination of process, mutuality
  • Abbreviations: NTEP, National TB Elimination Program.